Head injury

[Camron Rust]

Originally Posted by TimTaylor

Cam,

I believe that they did fix the private/public school differences issue in the last legislative session.

Looks like you are correct, if I am reading the reference I found correctly.....

https://www.oregonlegislature.gov/bi...5orLaw0392.pdf

Looks like a trainer or other defined healthcare professional can declare it to not be a concussion and the player can return for both public and private.

[scrounge]

Originally Posted by Camron Rust

Looks like you are correct, if I am reading the reference I found correctly.....

https://www.oregonlegislature.gov/bi...5orLaw0392.pdf

Looks like a trainer or other defined healthcare professional can declare it to not be a concussion and the player can return for both public and private.

Kind of an oddly written law....so a healthcare professional, as defined in the statute, can release an athlete but no sooner than the day after the event. However, a licensed trainer can release the athlete on the same day, regardless of consultation or opinion from a healthcare professional. Why not just include licensed athletic trainers in the definition of healthcare professional and allow them to release the athlete at any time?

Are trainers generally independent and free from undue influence from emotionally invested parties like coaches? If not, this is a fairly toothless law.

[SAK]

In Arizona we are told that if we suspect a head injury that we need to have the player evaluated by an appropriate medical professional and that we are to ask prior to the game if there is such a person on site (ideally meet them but sometimes they are at another event on campus). In Arizona the trainer is the medical professional as per the state association

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[PAlbc]

Originally Posted by scrounge

Kind of an oddly written law....so a healthcare professional, as defined in the statute, can release an athlete but no sooner than the day after the event. However, a licensed trainer can release the athlete on the same day, regardless of consultation or opinion from a healthcare professional. Why not just include licensed athletic trainers in the definition of healthcare professional and allow them to release the athlete at any time?

Are trainers generally independent and free from undue influence from emotionally invested parties like coaches? If not, this is a fairly toothless law.

As a Certified Athletic Trainer I'll chime in on this. First I would say that as a medical professional we should be able to conduct ourselves independently enough to ensure our medical decisions are not being influenced by our connection to a respective team. With that being said there are those out there that don't do that, just as there are officials out there that are biased for/against specific teams/coaches/players/etc. Again the majority out there act appropriately professional, you just hope you get to deal with those more often than the others.

With that being said ATCs have been given various levels of authority/responsibility when it comes to concussions. Much of it revolves around where the wording in a state law it goes from "suspected concussion" to "diagnosed concussion". In my state a player can be sent to me for a "suspected concussion/head injury", I can do an evaluation and say "No, this player does not have a concussion, they can return to play today." If I find they likely do have a concussion, they are not only done for the day, but they are done until cleared by a physician (and even can't be cleared by a physician same day).

If the laws and protocols didn't include athletic trainers and non-physicians in the "evaluation" process then essentially any time an official sent a kid out it would be essentially disqualification from participation for the remainder of the day and in some states permanently since wording includes "removed until evaluated by AHP". That's a lot of doctor's visits for kids based off of an official using an abundance of caution if other professionals can't handle the "evaluation" step.

I will say I have had this argument with officials who say "No, he has a concussion and can't return." I usually reply with "Thankfully my medical degree allows me to say your diagnosis of a concussion is wrong and he can return."

[PAlbc]

Originally Posted by SAK

In Arizona we are told that if we suspect a head injury that we need to have the player evaluated by an appropriate medical professional and that we are to ask prior to the game if there is such a person on site (ideally meet them but sometimes they are at another event on campus).

Even if your state protocol doesn't have you ask before a game, I would suggest it. It solves the problem immediately if it arises. You ask before the game if there is coverage by a medical professional, they say no, fine. That means if a potential head injury comes up, you indicate to the coach they are out until evaluated and by their own admission there is no one present to evaluate them, indicating that player is done for the day.

[Camron Rust]

Originally Posted by scrounge

Kind of an oddly written law....so a healthcare professional, as defined in the statute, can release an athlete but no sooner than the day after the event. However, a licensed trainer can release the athlete on the same day, regardless of consultation or opinion from a healthcare professional. Why not just include licensed athletic trainers in the definition of healthcare professional and allow them to release the athlete at any time?

Are trainers generally independent and free from undue influence from emotionally invested parties like coaches? If not, this is a fairly toothless law.

I don't think that is what it is saying.. If it IS deemed a concussion, they must wait a day before any clearance is valid. If it is deemed not a concussion, they can return the same day.

[scrounge]

Originally Posted by Camron Rust

I don't think that is what it is saying.. If it IS deemed a concussion, they must wait a day before any clearance is valid. If it is deemed not a concussion, they can return the same day.

That certainly seems to be what it says. As I read it, the plain text of subsection 3 (Sec1.3.a) requires the coach to hold out a player if only one of two conditions exist: signs, symptoms, or behaviors OR a diagnosed concussion. Sec1.3.b then clearly states that, if a players is held out under Sec1.3.a, upon approval of the healthcare professional (HCP), the player may return the next day if no signs, symptoms, or behaviors are present. In this case, both HCP approval AND lack of signs are required.

The only exception is that provided under subsection 4 (Sec1.4), the blanket provision allowing a licensed athletic trainer to make a final and unchallenged determination/diagnosis and same day return. This makes no sense to me - a trainer can return a player the same day but a neurologist can't. Doesn't that seem backwards?

[Camron Rust]

Originally Posted by scrounge

That certainly seems to be what it says. As I read it, the plain text of subsection 3 (Sec1.3.a) requires the coach to hold out a player if only one of two conditions exist: signs, symptoms, or behaviors OR a diagnosed concussion. Sec1.3.b then clearly states that, if a players is held out under Sec1.3.a, upon approval of the healthcare professional (HCP), the player may return the next day if no signs, symptoms, or behaviors are present. In this case, both HCP approval AND lack of signs are required.

The only exception is that provided under subsection 4 (Sec1.4), the blanket provision allowing a licensed athletic trainer to make a final and unchallenged determination/diagnosis and same day return. This makes no sense to me - a trainer can return a player the same day but a neurologist can't. Doesn't that seem backwards?

I think the protocol is that the trainer is the one that will be present, not the neurologist. If the immediate assessment is that it is not a concussion, the player can return. They'll never get to a neurologist before the game ends...but it allows for the trainer to consult with one if there is one available. However, once someone thinks it is a concussion (even the lessor trained trainer), it is treated as a concussion and the player must stay out for a minimum of time.

[SAK]

Originally Posted by Camron Rust

I think the protocol is that the trainer is the one that will be present, not the neurologist. If the immediate assessment is that it is not a concussion, the player can return. They'll never get to a neurologist before the game ends...but it allows for the trainer to consult with one if there is one available. However, once someone thinks it is a concussion (even the lessor trained trainer), it is treated as a concussion and the player must stay out for a minimum of time.

Where are you getting the minimum amount of time?

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[PAlbc]

No medical professional can clear a player to return same day when they have been determined to have suffered a concussion.

Appropriate medical professionals can evaluate a player and determine no concussion was suffered and thus return them to play that day. This could be an Athletic Trainer or Neurologist or other professional as specified.

Note: Even if concussion was not suspected, symptoms remaining precludes athlete from returning anyway.

I'll say again, the rules/laws are written to ensure that athlete's are removed and properly evaluated. Sometimes that means there is no concussion.

[Camron Rust]

Originally Posted by SAK

Where are you getting the minimum amount of time?

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It isn't a rule, but a state law. It is mentioned in the statute I linked to above.


Oregon State Law:

(a) A coach may not allow a member of a school athletic team to participate in any athletic event or training on the same day that the member:
(A) Exhibits signs, symptoms or behaviors consistent with a concussion following an observed or suspected blow to the head or body; or
(B) Has been diagnosed with a concussion.
(b) A coach may allow a member of a school athletic team who is prohibited from participating in an athletic event or training, as described in paragraph (a) of this subsection, to participate in an athletic event or training no sooner than the day after the member experienced a blow to the head or body and only after the member:
(A) No longer exhibits signs, symptoms or behaviors consistent with a concussion; and
(B) Receives a medical release form from a health care professional.
(4) A coach may allow a member of a school athletic team to participate in any athletic event or training at any time after an athletic trainer registered by the Board of Athletic Trainers determines that the member has not suffered a concussion. The athletic trainer may, but is not required to, consult with a health care professional in making the determination that the member has not suffered a concussion.

[mutantducky]

this was a good story on concussions, not really related but shows how you should be careful and how there should be strict rules in place.


http://www.nytimes.com/2015/12/14/sp...ocol.html?_r=0